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The Courts

March 20, 2019 | Daily News

Advocates for Medicaid beneficiaries filed a third lawsuit Wednesday (March 20) challenging the Trump administration’s continued approval of Medicaid work requirements.

March 19, 2019 | Daily News

The class action lawsuit spearheaded by Wisconsin-based Common Ground Health Cooperative and involving about 90 other exchange issuers has filed an amended complaint with the Federal Court of Claims and now seeks to collect cost-sharing reduction reimbursements owed for plan years 2017, 2018 and 2019.

March 14, 2019 | Daily News

A federal judge said he hopes to rule on the legality of Medicaid work requirements in Arkansas and Kentucky by the end of the month, unveiling his plan to decide quickly at the conclusion of back-to-back court hearings Thursday (March 14) that tested the reasoning behind one of the Trump administration’s most controversial health care priorities.

March 13, 2019 | Daily News

The Department of Justice is asking a federal court to dismiss a lawsuit brought by five major cities who charge the administration is violating the Constitution through its efforts to sabotage the Affordable Care Act.

March 13, 2019 | Daily News

Lawyers for Medicaid beneficiaries and the federal government will square off Thursday (March 14) for round two of the high-profile litigation over the legality of Medicaid work requirements—and the arguments they make likely will sound familiar.

March 08, 2019 | Daily News

The Depart of Justice immediately appealed a closely watched lawsuit worth potentially billions of dollars to dozens of insurers late Thursday (March 7) after a federal court formally ordered the government to pay Community Health Choices a total $71 million in cost-sharing reduction reimbursements for the 2017 and 2018 plan years.

March 08, 2019 | Daily News

A coalition of business groups and other stakeholders tell Senate health committee Chair Lamar Alexander (R-TN) and ranking Democrat Patty Murray (WA) that repealing the Affordable Care Act’s 40 percent tax on high-cost plans would be a critical first step in improving the health system, and also urge the lawmakers to reject any attempt to tax employer-sponsored coverage.

March 06, 2019 | Daily News

The Department of Justice is asking the federal claims court to issue a final judgment of about $71 million in 2017 and 2018 cost-sharing reduction payments for Community Health Choice (CHC), in order to smooth the way for a quick appeal, but wants the court to wait until CMS completes the 2018 reconciliation process before entering a judgment for Maine Community Health Options (MCHO) and the class action suit led by Common Ground Health Co-Op.

March 05, 2019 | Daily News

Republican Sen. Susan Collins (ME) joined a group of Senate Democrats and advocacy groups on Tuesday in expressing opposition to Sixth Circuit Court of Appeals nominee Chad Readler, arguing that Readler’s controversial refusal to fully defend the Affordable Care Act against a constitutional challenge while at the Justice Department disqualifies him from a promotion.

March 05, 2019 | Daily News

The federal government has asked the federal D.C. district court to dismiss hospitals’ request to scrap lower reimbursement for 340B drugs in 2019 by pointing back to arguments it used to defend the agency’s initial 2018 cuts, which the court found were beyond CMS’ authority.

March 05, 2019 | Daily News

The government appealed a D.C. federal district court ruling that found CMS did not have authority to cut reimbursement for 340B drugs by almost 30 percent in 2018, but both the agency and the hospitals are asking to put the appeal on hold until the lower court makes a decision on how the situation should be rectified.

March 04, 2019 | Daily News

A federal judge last week granted a short deadline extension for the federal government and health insurance plans to report to the U.S. Court of Claims the amount of reimbursement issuers are owed for the 2017 and 2018 cost-sharing reductions following the outcome of three similar lawsuits.

March 01, 2019 | Daily News

The coalition of groups suing to overturn the administration’s expansion of short-term plans is asking a federal judge to immediately rule in its favor, and the Department of Treasury, which is defending the plans, is also seeking a quick resolution.

February 26, 2019 | Daily News

Ten newly elected Democratic governors warned HHS that they would sue unless the administration rescinds the so-called ‘gag rule” that restricts Title X funding to facilities that either perform abortions or refer patients for abortions.

February 20, 2019 | Daily News

The National Home Infusion Association is asking the federal DC district court to make CMS withdraw and rework its final rule setting interim home infusion payments, in a lawsuit filed Feb. 14.

February 19, 2019 | Daily News

In a win for generic drug makers, the Supreme Court on Tuesday (Feb. 19) left in place a lower court ruling that struck a Maryland law against generic drug price gouging.

February 17, 2019 | Daily News

The U.S. Court of Federal Claims handed issuers major wins in four cost-sharing reduction (CSR) cases, including a class action suit brought by Wisconsin’s Common Ground Health Cooperative in which Judge Margaret Sweeney ruled that the government is responsible for reimbursing plans unpaid CSRs in 2017 as well as in 2018, despite the silver-loading workaround. Sweeney issued that decision on Friday (Feb. 15), the same day she ruled in favor of Texas non-profit Community Health Choices and Maine Community Health Options.

February 15, 2019 | Daily News

The insurance industry notched a win Friday with a federal judge ruling that the Trump administration violated the Affordable Care Act and breached an implied contract when it cut off cost-sharing reduction payments and is responsible for reimbursing Texas non-profit plan Community Health Choices, Inc. (CHC) for not only the fourth quarter of 2017, but also for 2018, despite the silver-loading workaround that resulted in higher premium tax credits.

February 15, 2019 | Daily News

Hospitals that sued CMS over cuts to reimbursement for 340B drugs are asking the court to make CMS recalculate payments to make up for those cuts, but the government says that would require all hospital outpatient payments be recalculated in order to keep the pay system budget neutral and tells the court to let CMS figure out how to fix the situation.

February 15, 2019 | Daily News

Hospitals are asking a federal court to give CMS 30 days to scrap its plans to continue lower reimbursement for 340B drugs in 2019, as the court already found the 2018 pay cuts beyond the scope of the agency’s authority.